Provider Demographics
NPI:1497724553
Name:VANDONGE, ANGELA (ARNP)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:VANDONGE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 361
Mailing Address - Street 2:
Mailing Address - City:BASEHOR
Mailing Address - State:KS
Mailing Address - Zip Code:66007-0361
Mailing Address - Country:US
Mailing Address - Phone:913-269-3447
Mailing Address - Fax:
Practice Address - Street 1:757 W EISENHOWER RD
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:KS
Practice Address - Zip Code:66043-2215
Practice Address - Country:US
Practice Address - Phone:913-534-8336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13-86581-012363LF0000X
KS45552363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
161602Medicare ID - Type Unspecified
Q64352Medicare UPIN